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Wednesday, February 10, 2016

Overreacting

We are so accustomed to throwing around terms of which we no longer understand the definition. Today's example is the use of the term: "ER". Back in the good ole days, this was an abbreviation for the words "Emergency Room".
Emergency is defined as: A serious, unexpected, and often dangerous situation often requiring immediate action: a medical condition requiring immediate treatment.
Problems fitting this description were taken to a special area of the hospital known conveniently as the "Emergency Room". Pretty self-explanatory, right?

Woefully Overwrought Woman: I need to find this product now!
CP: What seems to be the problem?
WOW: My son has this infection and the doctor told me I could buy it over the counter. They wouldn't even give me a prescription for it.
CP: Okay. Let me come out to show you what you need.
WOW: They said to get some type of cream, but did not tell me which one.
CP: Fine. What are we treating?
WOW: Ringworm.
CP: Uh-huh. Well I like Lamisil because the treatment period is shorter and the box is pretty shades of blue. How old is your son?
WOW: He's in his twenties.
CP: Got it. Well this is safe for a boy of his age. You may bring this to my register if you desire.
WOW: No. He needs it right now. Looks like we wasted an ER trip last night for nothing.
CP: You took him to the ER for this?
WOW: Yes! He said it really bothered him.
CP: When did this sudden, emergency infection afflict him?
WOW: He said he's had it for about 3 months now.
CP: I see. I see. Definitely a good thing to take him to the ER last night. I'm sure he couldn't have waited another 6 hours to be seen in his doctor's office. I really hope no real emergencies came through the EMERGENCY ROOM while he was occupying a bed with his horrible case of ringworm.
WOW: Well I never!
CP: Oh but you should have. A long time ago.


Monday, February 8, 2016

This...

This is why...
I had counseled a woman a few weeks back on how to taper/adjust her new medication to avoid side effects and find the lowest effective dose for her. She returned over the weekend to ask a few more questions and tell me she was feeling better.
Awesome Lady: Thank you so much for helping me. I have a few more questions.
CP: Wonderful. Here are your answers.
AL: Thanks again. I really appreciate your help.
CP: You are welcome. It's what I do.
<she walks away>

AL: Wait.
<does a 180 and returns>
CP: Yes?
AL: I almost forgot.
CP: You did. But you remembered.
AL: I had an appointment with my doctor and told him everything you told me to do.
CP: <GULP> Really?
AL: Yes! He said that was the best thing I could have done. He said your advice was perfect and I should follow it all the time. He was really impressed with your advice and said I was lucky to have you as my pharmacist.
CP: Well, thank you. That is high praise indeed.
AL: I always knew to trust you more than my doctors, but it was nice to hear him praise you as well. Just thought you'd like to know.
CP: Again, thank you. That made my day.

Wednesday, February 3, 2016

OPP

Why is it going to take so long?
OPP!
What?
OPP!
What?

OPP how can I explain this
Listen hard so you don't miss
To understand the day of your pharmacist
O is for Other, P is for People now that's simple,
The last P, well, here's an example
It's a paper that your doctor gives that tells me what to fill
I use it then to label bottles of pills
You bring it to the pharmacy if it's written out for you at leavin'
It seems I gotta start to explainin'
Trust it
You ever get all sick and know you need a medicine
You see your doc and get a slip and now you think that you're all in
You head down to the drug store knowing that it just can't wait
Then you see a line and now it looks like you'll be running late
S to the C to the R to the I to the P to the T
The rest of town is sick now too (oh no what a pity)
It's OPP,  time to grab a chair and sit in it
Won't help you by complaining none so come back to get it

You down with OPP?
Yeah you know me!
You down with OPP?
Yeah you know me.
Who's down with OPP?
All the pharmies!

Friday, January 29, 2016

What Separates us from Street Dealers (If the real world worked...)

Random thoughts that enter my head get turned over, chewed up, then spit out here for your amusement. Or derision. Let's go with amusement.
I do not like plastic bags for prescriptions. I wrote a post about this before. I tell my techs that street drugs come in plastic baggies, not prescriptions.

Building upon that, I had another thought yesterday. We received a few patients yesterday that had not filled with us in some time. Whether for insurance issues, relocation issues, or spite, they left us. Now they had returned. Companies want us to be jealous. They want us to compete for the affections (and money) and loyalty of every living, breathing human on the planet. Which led to me pondering if the local street dealers go out of their way to be jealous.

SD: So...where ya been? Haven't seen you around lately.
Local User: <looking down, shuffling feet> Had to transfer corners, man. Not allowed to cross the street anymore.
SD: Still got your stuff. I'm offering a coupon to all my regulars who return.
LU: Really? Is it good on anything?
SD: Yep.
LU: I changed my regular order while I was gone. The other guy was using some other supplier and his stuff wasn't as good as yours. I needed to change it up a bit.
SD: Well I got just what you need. Transfer all your orders to me and we can set you up with reminder texts, phone calls to get your next order placed, discount cards from my suppliers on their products, and we can even give you Naloxone in case you OD.
LU: Really? No one else offers that.
SD: It is incumbent upon me to satisfy the needs of my customers. I'm in the business of making money. Dead clients don't pay.
LU: What?
SD: I mean, it's business. The more I can get you to come to me to buy, the more money I can make. The more money I can make, the less the other guy makes. Eventually I can buy out his corner too.
LU: Thanks. I'm glad I came back. I didn't realise you offered all those services. You're such a caring dealer. You really care about my high and...
SD: Yeah yeah yeah. NEXT!

Thursday, January 28, 2016

PayDay Med Advance

(Another in the series of "If the real world worked the way people believe Pharmacy does".)

My next business model for the phuture of pharmacy is to incorporate a Cash Advance system into our stores. If a person goes to a bank and whines that they are out of money until payday or they will die without $10.00 to get them through the weekend, the bank does not provide them a handout. The bank does not say "we will take it out when you come back with your check on Monday". This led to the proliferation of the Payday Loan establishments.

Initially, our model would open up inside a pharmacy. It would be an adjoining window, like a walk-up teller or ticket booth. Since we would have access to the patients' files, we could provide instant access to their medications. Eventually, and herein lies the beauty of the system, once pharmacists receive their limited prescribing status, our established business model would allow for freestanding stores to be built. Instead of being attached to a pharmacy, we could build on an outparcel in front of the pharmacy. We would be cash only of course.
While I'm shooting for the stars, let's assume we are able to get contracts with the major pharmacies in town to access their software. This way, we could operate one mini-PayDay Med Advance pharmacy in a town with a CVS, Walmart and Walgreen's.

Mr. No Refill Guy: I'm out of refills and I'm going to die.
CP: CP to the rescue. I can write you a prescription for enough medication to last until your appointment next week.
MNRG: Gosh. That'd be swell.
CP: Please see our rates on the board behind me.

Requires CP to write a prescription: $25.00 each
Filling of prescription: $15.00 (this is the dispensing fee w/o medication)
Medication: Cost of med (acquisition cost) plus 20% plus $10.00

MNRG: It's going to cost me $50.00 for this?
CP: Yes. And that is before I put any medication in your bottle.
MNRG: That's ridiculous.
CP: Perhaps. But I don't want you to die.
MNRG: Can you bill my insurance?
CP: For the medication I can. The $50.00 in fees still applies and is cash only.
MNRG: I think I'll just die.
CP: At that point it would be your choice. Keep in mind, as I'm sure we've reminded you in the past, the ER is always an option for those who don't want to die. This is a simpler, faster, cheaper alternative.
<waves bottle of medication in front of patient's face; gives them a taunting shake>
MNRG: Fine. I'll take them.
CP: Good. See you next month.

Monday, January 25, 2016

Because...Beer Remembers

Why is American Beer like making love in a canoe?
They're both fucking close to water. 
#montypython

I developed this business idea. My goal is to start small, then grow the business in every Pharmacy College town...and towns that have liquor establishments. Here's the idea:

After the weekend parties, I will have college students collect all the empty beer bottles and cans from all the fraternities and sororities on campus. They will bring them to my labrewery. 
Each bottle will be filled with water. 
Each bottle will be emptied into a large vat. 
Each bottle will again be filled. Then dumped. 
This will occur 11 times. 
After the vat has been filled, the contents will be slowly swirled. 
The next step in the process will be packaging. 
The vat will be emptied into individual bottles for distribution and sale. 
Initially I expect to use 30 ml bottles with droppers. 
The bottles will then be labeled and priced for retail sale at our store/pharmacy and on campuses and in bars across the country. 

Directions for use will appear on the label as follows:
"For prevention of intoxication, place 1 dropperful (1ml) under tongue once a day."
"Additionally, to prevent hangover from a night of binge drinking, take 5ml (5 droppers full) at least 2 hours before imbibing."

How it works...
Beer Homeopathy works as follows: Water has a memory. Beer is made of water. Therefore, beer has memory. By introducing minute, infinitesimally small, untraceable, immeasurable amounts of beer to your system on a daily basis, you can prevent hangovers and drunkenness from ruining your next party. 

Monday, January 18, 2016

It's Just a Word

Some words become overused to the point where people do not understand their definition anymore. A few that fall into this category, from strictly a speaking standpoint, would be "so", "like", and "literally".
"So" has become an introductory pause, effectively updating "um".
The abuse of "like" can be heard from any teenager, but is best exemplified by watching "The Valley Girls". Like, totally...
It "Literally" makes me want to gag myself with a spoon. Not!

Okay. Why the stupid lesson with words you use more smarterer than us?
Phunny, and it would be "words you use better than we..."
I just wanted to add one more word to the list.
It's just a little word.
We hear it at work every day.
It's directed towards us to oversimplify what we do.
Just.

According to definition #4 of the Oxford Dictionary, "Just" is defined as: "Simply; only; no more than."

As in:
It's just a refill.
It's just a box.
You just have to slap a label on it.
Why is it so expensive? It's just an antibiotic.
Why so much? It's just an eye drop.
Why is it taking so long? It's just one tablet.
I just have a question.

Unfortunately, we are often guilty of committing this error. How often does a person bring a bottle to the counter and our initial response is: "You just have a refill"?
Or we have to add insurance or a discount card when the patient is at pickup and our techs tell them "It'll just be a minute".

Everything takes time.
Give people a realistic expectation.
Maybe they'll learn.
If not we can stab them with our finely sharpened Spatula Kitanas and tell them it's just a flesh wound...


Wednesday, January 13, 2016

Is That Long For Something?

Names. I've done rants before about names and how they affect profiles. 
Hyphenated names? Hate them. 
Father-Son with the same name? Expect problems. 
Mother-Daughter with the same name? Ditto. 
Twins named Lynn and Lyn? #STFU
Triplets named Sean, Shaun, and Shawn? #GTFO

As complicated as the patients like to make our lives, and thereby their own, sometimes you just can't help some people. The following example will illustrate how it's not always the phault of the patients. 

Fade In. Monday. Bright Pharmacy Lights. (Imagine the sound of Law & Order with a Dunh-Dunh.)
The set up: Pharmacy sends refill request to prescriber. 
Prescriber returns faxed request with the following note: 
"Not. Our. Patient."

CP: Hello? Mr. Guy? 
LTCG: Yes. Speaking. 
CP: I am calling today to notify you that your prescriber denied your refill request. 
LTCG: What? Why? 
CP: Well, someone at the office scrawled across the top: "Not our patient". 
LTCG: What? I've been a patient there since they opened that office. Are you calling the correct place? 
CP: Yes. Perhaps you should call them. 
LTCG: I will. <click> 

Tuesday. (Dunh-Dunh)

LTCG: I spoke with the office. They said they haven't received anything from you. 
CP: Phunny. 
LTCG: They gave me another phax number to try. 
CP: Okay. Let's have it. I shall try this one. Did you ask them to take the refill request over the phone? 
LTCG: They said they require a phax. 
CP: If I am to understand, you had the office on the phone. To refill a prescription. That is yours. With them. We are too incompetent to send a phax correctly, yet they and you are dependent upon me to accomplish this? 
LTCG: Essentially. 

Wednesday. (Dunh-Dunh)
A new phax arrives: "NOT. OUR. PATIENT"

CP: Guess what? 
LTCG: What? 
CP: Chicken Butt. 
LTCG: Again? 
CP: Yep. 
LTCG: You need to call them. 
CP: I will. If for no reason other than I cannot wait to see how this one ends. 

Thursday (DUNH-DUNH!)

Dr. Zoffis: Allo?
CP: Hi. We have been trying to get a refill authorization from your office for our mutual patient. We have sent phaxes to you on Monday, Tuesday, and Wednesday, per your requirement. To his credit, Mr. LTCG has phoned your office on these days as well. Each of our requests has been returned with the following note: Not Our Patient. Can you explain how this could be? 
DZ: Yes. (and I quote) "You sent us a refill request for a Lawrence The Cable Guy, DOB 2/17/63. We have a LARRY The Cable Guy, DOB 2/17/63 but NOT a Lawrence." 
CP: Okay. Can you hold while I slam the phone into my phorehead a few times before returning to make phun of you and your staff? 
DZ: Sure. 
<CP slams phone into phorehead>
CP: Do you have any Tom's or Tommy's there? Perhaps a Thomas? Joe? Joseph? Joey? Jen or Jennifer or Jenny? Mike or Michael? Ooh Ooh..How about a Jon or John or Johnathan? You had the patient's name. The DOB. The address. The phone number. They all matched. You have officially lowered the bar on stupidity's expectations. No. You grabbed the bar, dug a hole, threw the bar into the hole, then jumped on it. Criminals taking selfies at the crime scene then posting them on social media are laughing at you right now.